Amid intensifying conflict, MSF cared for an increasing number of patients and responded to growing medical needs. MSF focused on improving access to emergency, pediatric, and maternal health care in Afghanistan, which has one of the highest maternal mortality rates in the world. A quarter of all the births assisted by MSF worldwide were in Afghanistan, and teams helped deliver more than 66,000 babies in 2016.

MSF pursued negotiations with all parties to the conflict regarding the need to ensure a safe humanitarian space. After US military airstrikes destroyed its trauma center in Kunduz in October 2015, killing 42 people, MSF engaged in intensive advocacy to call for the protection of medical facilities from attack. At the end of 2016, MSF obtained commitments that its staff and patients would be respected, and care could be provided to everyone in need, regardless of their ethnicity, political beliefs, or allegiances. MSF was evaluating the possibility of resuming trauma care activities in Kunduz in 2017.

As the capital, Kabul, has experienced massive population growth, the city’s public health services have been overwhelmed. At Ahmad Shah Baba district hospital in eastern Kabul, which serves more than 1.2 million people, MSF supported the Ministry of Public Health to deliver outpatient and inpatient care, with a focus on maternal health and emergency services. MSF increased the capacity of the hospital and started to rehabilitate the buildings. Staff conducted 100,000 consultations and assisted 18,966 deliveries, almost 20 percent more than in 2015.

MSF collaborated with the Ministry of Public Health to provide around-the-clock care at Kabul’s Dasht-e-Barchi hospital, the only facility for emergency and complicated deliveries in the district. Teams assisted 15,627 deliveries, almost 27 percent of which were complicated cases.

MSF’s maternity hospital in Khost, in eastern Afghanistan, has helped reduce maternal mortality by offering a safe environment for women to deliver their babies in the care of predominantly female medical staff, free of charge. The number of deliveries reached 21,335 in 2016, a 40 percent increase over two years. In 2016, MSF began supporting three health centers in outlying districts in Khost province to increase their capacity to assist normal deliveries.

Since 2009, MSF has supported Boost provincial hospital in Lashkar Gah, Helmand province, one of only three referral hospitals in southern Afghanistan. In 2016, the team completed the rehabilitation of the original hospital building and extended the maternity department. Staff assisted 10,572 deliveries in 2016. The hospital has a neonatology unit and pediatric department where 2,431 children were treated for malnutrition in 2016.

MSF started supporting the diagnosis and treatment of drug-resistant TB (DR-TB) in Kandahar province. MSF provided additional staff at Mirwais hospital and organized training for other facilities to improve case detection.

Update: October 2015

At least 42 people, including 14 MSF staff and 24 patients (three of which were children), were killed in sustained airstrikes on the MSF hospital in Kunduz, Afghanistan, on Saturday, October 3, 2015. Dozens more were injured.

We demand a full transparent and independent international investigation by the International Humanitarian Fact-Finding Commission (IHFFC.org) into the attacks.